title: Occult hepatitis C virus infection in candidates for liver transplant with cryptogenic cirrhosis.
abstract: BACKGROUND
  Occult hepatitis C virus (HCV) infection is a new entity described by the presence of HCV-RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) specimens, and undetectable levels or absence of HCV-RNA and in the absence or presence of anti HCV antibodies in plasma by current laboratory methods.
  
  
  OBJECTIVE
  To evaluate the detection of HCV-RNA in PBMC specimens of the liver transplant candidates with cryptogenic cirrhosis by reverse transcriptase-nested polymerase chain reaction (RT-nested PCR).
  
  
  METHODS
  From November 2007 to March 2013, 45 patients from Liver Transplant Center of Imam Khomeini Hospital, Tehran, were enrolled in this cross sectional study. PBMC specimens were separated from the peripheral blood sample. After extraction of RNA from plasma and PBMC specimens, HCV-RNA status was tested by RT-nested PCR. The 5'-untranslated region (5'-UTR) genotyping of HCV-RNA amplified from PBMC specimens was performed by a standard methodology with the INNO-LiPA(TM) HCV II kit. The PCR products of 5'-UTR were sequenced after cloning into the pJET1.2 / blunt cloning vector.
  
  
  RESULTS
  Of 45 patients, 4 (8.9% [95% CI: 4.4-15.6]) had detectable genomic HCV-RNA in their PBMC specimens. HCV genotypes were determined in the PBMCs of these subjects showed that 2 (50.0%) subjects with occult HCV infection had HCV subtype 3a, and 2 (50.0%) had HCV subtype 1b.
  
  
  CONCLUSIONS
  This study found that 8.9 % of the Iranian candidates for liver transplant with cryptogenic cirrhosis had occult HCV infection. Therefore, designing prospective studies focusing on the diagnosis of occult HCV infection in these subjects prior to liver transplantation could be valuable.
authors.affiliation: Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
authors.forename: Farah
authors.initials: F
authors.lastname: Bokharaei-Salim
authors.forename: Seyed Hamidreza
authors.initials: SH
authors.lastname: Monavari
authors.forename: Maryam
authors.initials: M
authors.lastname: Esghaei
authors.forename: Mohssen
authors.initials: M
authors.lastname: Nassiri Toosi
authors.forename: Shahin
authors.initials: S
authors.lastname: Fakhim
authors.forename: Zohreh Azita
authors.initials: ZA
authors.lastname: Sadigh
authors.forename: Seyed Moayed
authors.initials: SM
authors.lastname: Alavian
keywords: Cirrhosis; Cryptogenic; Hepatitis C Virus; Liver Transplantation; Occult Infection; Peripheral Blood Mononuclear Cells